PurposeThe objective of the present study was to compare different off-midline techniques in terms of their advantages and disadvantages.MethodsA total of 81 patients were included in this prospective, controlled, randomized study. Patients in group 1 were treated with the Limberg flap, and patients in group 2 were treated with Mutaf technique. Patients were followed up for 9 months postsurgically and assessed at regular intervals.ResultsA total of 41 and 40 patients received surgical treatment with Limberg or Mutaf techniques, respectively. The 2 groups were similar in terms of age, gender, body mass index, and Tezel pilonidal sinus classification. Also, the 2 groups were comparable with regard to the frequency of preoperative discharge from the wound site, history of abscess formation, and the resultant antibiotic use. Early results showed similar recurrence rates and surgical-site complications between the 2 groups. Although a lower visual analogue scale score was found in group 2 at postoperative day 1, seroma persistence, time to withdrawal of surgical drains, and wound healing were more prolonged.ConclusionIn this study, Mutaf technique was comparable to Limberg flap in the treatment of pilonidal sinus. Therefore, Mutaf technique may be offered as a viable surgical therapeutic option among off-midline closure approaches.

No abstract

Malign melanomda cerrahi sonrası adjuvan immunoterapi ve kemoterapi deneyimimiz Our postoperative adjuvant immunotherapy and chemotherapy experience in malignant melanom Amaç: Malign Melanom(MM) melanositlerden köken alan, görülme sıklığı artmakta olan ve cilt kanserlerinden ölümlerin %65'ine sebep olan bir hastalıktır. Öncelikli tedavi cerrahi olarak total eksizyondur. Cerrahi sonrası yapılan adjuvan tedaviler hastalığın toplam ve hastalıksız yaşam süresini uzatmak amaçlı kullanılmaktadır. Bu çalışmanın amacı cerrahi sonrası yapılan adjuvan immunoterapi ve kemoterapinin etkisini belirlemek olmuştur. Gereç ve Yöntem: Bu çalışma prospektif, tek kollu bir çalışma olarak planlandı. Çalışma kabul kıriterlerine uyan 31 hastaya cerrahi sonrası yüksek doz adjuvan interferon ve/veya decarbazin uygulandı. Hastaların demografik verileri, hastalık evreleri, yapılan cerrahi işlemler, takip süresince toplam ve hastalıksız yaşam süreleri kaydedildi. İstatiksel analizler yapıldı. Bulgular: Hastaların 18'i (%58) erkek, 13'ü (%42) kadındı. Grubun yaş ortalaması 52.6 yıl olarak belirlendi. Hastalar ortalama 17.58 ay süre ile takip edildi. Toplam yaşam süresi analizinde, ortalama yaşam süresi 11 (min: 9, max: 24) ay, ortalama hastalıksız yaşam süresi 10±1.6 ay olarak bulundu. Sonuç: MM da cerrahi sonrası adjuvan immunotepinin hastalıksız sağ kalım süresini uzattığı ayrıca adjuvan immunoterapi + kemoterapinin de hastalıksız ve toplam yaşam süresini uzattığı daha önce yapılan çalışmalarda belirtilmişti. Bu çalışma da bir ara sonuç olarak kabul edildi ve de takip süresi uzadıkça hastalıksız ve toplam sağ kalım üzerine etkisinin gözlemleneceği kabul edildi.

No abstract

Objectives.Rates of negative laparotomy (NL) for acute appendicitis have been reported as 15% and parasitosis contributed to 2%. This study was planned to reduce the rates of NL by preoperative determination of parasitosis.Methods.In retrospective examination of 2730 appendectomy specimens in Hitit University Department of General Surgery between 2008 and 2012, 55 patients were determined with parasitosis and compared with 102 age-matched randomly selected patients with lymphoid hyperplasia.Results.The parasite group comprised 63.6% females with a mean age of 15.1 years. The number of patients in the parasitosis group increased from city centre to rural areas of towns and villages (p<0.001). While a lower rate of sonographic findings was found in the parasitosis group, the findings of inflammation in the histopathological evaluation were significantly low (p=0.014,p=0.0011, resp.). A significant difference was determined between groups in respect of the eosinophil and haematocrit values. In the differentiation of patients with parasites, eosinophil of >2.2% was determined as a diagnostic value.Conclusion.It is important to determine parasitosis to prevent NL. When acute appendicitis is considered for young patients living in rural areas, the observation of high eosinophil together with negative sonographic findings should bringEnterobius vermicularisparasitosis to mind and thereby should prevent NL.